Measurement of erythrocyte methotrexate polyglutamate levels: Ready for clinical use in rheumatoid arthritis?

Maria I. Danila, Laura B. Hughes, Elizabeth E. Brown, Sarah L. Morgan, Joseph E. Baggott, Donna K. Arnett, S. Louis Bridges

Research output: Contribution to journalReview articlepeer-review

26 Scopus citations


Methotrexate (MTX) is one of the most commonly prescribed and most effective drugs for the treatment of rheumatoid arthritis (RA). Given the partial response of many patients and the side effect profile of the drug, there is considerable interest in identifying biomarkers to guide MTX therapy in RA. Upon entering cells, MTX is polyglutamated. Measuring MTX polyglutamate (MTX PG) levels in circulating red blood cells has been proposed as an objective measure to help optimize MTX therapy in RA. Data are conflicting with regard to the clinical utility of MTX PG measurements as a predictor of the efficacy or toxicity of lowdose MTX effects in RA. Should large, randomized clinical trials of this assay show consistent, reproducible, long-term correlations between MTX PG levels and efficacy or toxicity, this test could become a prominent tool for clinicians to optimize the use of MTX in treating RA.

Original languageEnglish
Pages (from-to)342-347
Number of pages6
JournalCurrent Rheumatology Reports
Issue number5
StatePublished - Oct 2010

Bibliographical note

Funding Information:
Acknowledgments This work was supported by National Institutes of Health grants 2P60 AR048095-06 (University of Alabama at Birmingham Multidisciplinary Clinical Research Center, R. P. Kimberly, principal investigator) and the MCRC Project 1 (D. K. Arnett, principal investigator).


  • Methotrexate
  • Polyglutamates
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Rheumatology


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